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Safety and efficacy of trigonal BTX-A injections for children with neurological detrusor overactivity secondary to spinal cord injury.
Journal of Pediatric Surgery ( IF 2.4 ) Pub Date : 2020-05-23 , DOI: 10.1016/j.jpedsurg.2020.05.019
Chen Hui 1
Affiliation  

Objective

To evaluate the efficacy and safety of trigonal botulinum toxin A (BTX-A) injections for children with neurological detrusor overactivity (NDO) secondary to spinal cord injury (SCI).

Methods

From February 2012 to December 2018, children with NDO secondary to SCI were enrolled. All patients received 200U BTX-A intradetrusor injections including the trigone. Videourodynamic study was performed at baseline and 12 weeks after injection. The primary outcome measures were the presence of vesicoureteral reflux and standardized urodynamic measures. Secondary outcomes included incontinence quality of life questionnaire (I-QoL), voiding volume, urinary incontinence episodes, and complete dryness.

Results

A total of 33 pediatric inpatients (28 male and 5 female) completed the study. No one developed VUR at week 0 or week 12. At the first instance of NDO, maximum detrusor pressure (PdetmaxFNDO) and NDO duration were reduced by 29.8% and 31.8%, respectively, whereas NDO volume (VFNDO) increased by 50.5%,12 weeks after injection. Mean urinary incontinence episodes were reduced by 31.7%, whereas voiding volume and I-QOL were increased by 52.9% and 23.3%. 3 patients reported mild transient hematuria during the first week after injection.

Conclusions

Our results suggest that the use of bladder-trigone-including intradetrusor BTX-A injection does not induce VUR, and is safe and effective in children with NDO secondary to SCI.

Type of study

A prospective self-controlled trial

Level of evidence

Level II



中文翻译:

三角BTX-A注射液对继发于脊髓损伤的神经逼尿肌过度活动的儿童的安全性和有效性。

目的

评估三角肉毒毒素A(BTX-A)注射液对继发于脊髓损伤(SCI)的神经逼尿肌过度活动症(NDO)的儿童的疗效和安全性。

方法

从2012年2月到2018年12月,招募了SCI继发的NDO儿童。所有患者均接受了200U BTX-A Intrutrusor注射,包括Trigone。在基线和注射后12周进行视频尿动力学研究。主要结局指标为膀胱输尿管反流和标准化尿动力学指标。次要结局包括尿失禁生活质量问卷(I-QoL),排尿量,尿失禁发作和完全干燥。

结果

共有33名儿科住院患者(男28例,女5例)完成了研究。在第0周或第12周,没有人出现VUR。在NDO首次出现时,最大逼尿肌压力(PdetmaxFNDO)和NDO持续时间分别减少了29.8%和31.8%,而NDO量(VFNDO)增加了50.5%,12注射后几周。平均尿失禁发作减少了31.7%,而排尿量和I-QOL分别增加了52.9%和23.3%。3名患者在注射后的第一周报告了轻度短暂性血尿。

结论

我们的研究结果表明,使用膀胱三酮类药物(包括Intrutrusor BTX-A注射液)不会诱发VUR,对于继发于SCI的NDO儿童是安全有效的。

学习类型

前瞻性自我对照试验

证据水平

二级

更新日期:2020-05-23
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